HSJ’s round-up of the must read stories from Wednesday

Change coming to Southern Health?

There were two pieces of bad news for Southern Health Foundation Trust on Wednesday.

The first was that the CQC had issued it with a warning notice requiring improvements to its safety governance.

The CQC took the action following an inspection of the mental health and learning disability services provider in January, which was prompted by last year’s highly critical review of Southern Health by Mazars. The audit firm highlighted failures at the trust to properly investigate and learn from patient deaths.

While the CQC is not set to publish its full inspection report until the end of this month, the warning notice is an indication that the regulator had sufficiently serious concerns about the trust that it was not able to wait until publication before demanding action.

The second piece of bad news was NHS Improvement’s announcement that it intends to add a condition to Southern Health’s licence, allowing it to make “management changes” if the CQC’s concerns are not rapidly addressed.

Kathy Mclean, NHS Improvement’s medical director, said it was “worrying” the CQC had identified problems relating to investigating and learning from incidents that had “still gone unaddressed”.

The CQC’s comment that Southern Health had “failed to mitigate significant risks posed by some of the physical environments” is particularly troubling, giving the circumstances of Connor Sparrowhawk’s death three years ago, which triggered the Mazars review.

Southern Health’s leadership has been under huge pressure since the publication of the report, but there have not been departures from the board to date.

NHS Improvement’s threat is a warning that unless the trust can demonstrate progress fast, that could change.

RCS slams CCGs

Six CCGs in the Midlands have been accused of ignoring or misrepresenting clinical guidance in order to restrict access to vital surgery.

The Royal College of Surgeons has written to the CCGs in the Midlands strongly urging them to rethink their joint consultation on procedures of lower clinical value, which it says could put patients at risk.

The letter, sent on Tuesday from RCS council member and commissioning lead Paul O’Flynn, said: “Aspects of the policy amount to rigid thresholds which would act as a barrier to essential elective surgical procedures.

“The RCS has produced clear guidance, accredited by NICE, and this should be fully taken into account in CCGs’ commissioning policies. In this case, our guidance has been misrepresented and incorrectly referenced in many places.”

It criticised the CCGs’ decision to only refer patients for hip and knee surgery if their BMI is below 35, and to restrict surgical treatment to only the more advanced cases of varicose veins.

A spokesman for the CCGs told HSJ: “Along with a number of key stakeholders, the RCS was asked for its views as part of our procedures of lower clinical value engagement process; we have only just received their formal feedback. We are very pleased that the RCS has now formally commented, to enable us to make sure their views are considered fully and appropriately.”